Sleep Disordered Breathing: Surgical Outcomes in Prepubertal Children
Abstract
Objective To evaluate the treatment outcomes of sleep disordered breathing (SDB) in prepubertal children 3 months following surgical intervention. Study Design Retrospective investigation of 400 consecutively seen children with SDB who were referred to otolaryngologists for treatment. Method After masking the identities and conditions of the children, the following were tabulated: clinical symptoms, results of clinical evaluation and polysomnography at entry, the treatment chosen by the otolaryngologists, and clinical and polysomnographic results 3 months after surgery. Results Treatment ranged from nasal steroids to various surgical procedures. Adenotonsillectomy was performed in only 251 of 400 cases (68%). Four cases included adenotonsillectomy in conjunction with pharyngoplasty (closure of the tonsillar wound by suturing the anterior and posterior pillar to tighten the airway). Persistent SDB was seen in 58 of 400 children (14.5%), and an additional 8 had persistent snoring. Best results were with adenotonsillectomy. Conclusion SDB involves obstruction of the upper airway, which may be partially due to craniofacial structure involvement. The goal of surgical treatment should be aimed at enlarging the airway, and not be solely focused on treating inflammation or infection of the lymphoid tissues. This goal may not be met in some patients, thus potentially contributing to residual problems seen after surgery. The possibility of further treatment, including collaboration with orthodontists to improve the craniofacial risk factors, should be considered in children with residual problems.
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Structural improvements, while maintained, may be insufficient on their own to ensure long-term functional stability.
“Given that childhood OSA is increasingly understood as a dynamic disorder influenced by structural, neuromuscular, and behavioral factors [19, 48, 49], this combined evaluation underscores that structural improvements, while maintained, may be insufficient on their own to ensure long-term functional stability.”
From Long-Term Changes Following Orthopedic Mandibular Advancement Therapy in Pediatric Obstructive Sleep Apnea: a 7-Year Follow-up Study (2026) · cites this paper as [19]
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“Given that childhood OSA is increasingly understood as a dynamic disorder influenced by structural, neuromuscular, and behavioral factors [19, 48, 49], this combined evaluation underscores that structural improvements, while maintained, may be insufficient on their own to ensure long-term…”
- Authors
- Guilleminault, C., Li, K. K., Khramtsov, A., Pelayo, R., & Martinez, S.
- Affiliations
- Stanford Medicine (US)
- Stanford University (US)
- Venue
- The Laryngoscope
- Publisher
- Wiley
- Published
- 2004-01
- Volume
- 114
- Issue
- 1
- Pages
- 132-137
- ISSN
- 0023-852X (ISSN-L)
- 1531-4995
- OpenAlex
- W2010627336
- Cited by
- 149
- References
- 12
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 11 · 2018: 8 · 2017: 6 · 2016: 6 · 2015: 14 · 2014: 4 · 2013: 7 · 2012: 12
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Laryngoscope (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Keywords
- sleep-disordered breathing, obstructive sleep apnea, prepubertal children, adenotonsillectomy, pharyngoplasty, upper airway obstruction, craniofacial structure, surgical outcomes, nasal steroids
- MeSH terms
- Adenoidectomy, Child, Female, Follow-Up Studies, Humans, Male, Pharynx, Preoperative Care, Retrospective Studies, Risk Factors, Sleep Apnea Syndromes, Time Factors, Tonsillectomy, Turbinates, Treatment Outcome, Polysomnography, Craniofacial Abnormalities, Sleep Apnea, Obstructive
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